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Dinesh* (name changed) lives in Sector 6, Rohini, a middle class neighbourhood in Northwest Delhi and earns a decent salary to sustain his family. His father was an employee of the Power Finance Corporation, a public sector undertaking (PSU) and retired seven years ago. He has been a diabetic for years and developed a kidney-related ailment recently, which has led to renal failure. Now, he undergoes dialysis three times a week. He is covered under the Central Government Health Scheme and hardly pays anything for his treatment. Luckily, he does not have to travel much for his dialysis at a private hospital in the area. But does everyone have this privilege of being covered under a centrally funded health scheme and easy accessibility to hospitals in the lockdown following the coronavirus outbreak?
Owing to an ill-planned lockdown, several patients are at the risk of losing their lives with the restrictions on movement--translating into restricted access to essential medicines and equipment.
NewsClick talked to the families of many such patients to understand their struggle for medical treatment amidst the lockdown. Pradeep Ram, a resident of Sanjay Jhuggi Basti in Timarpur and an auto rickshaw driver by profession, informed NewsClick that his 20-year-brother developed a chronic kidney disease a few years back and was undergoing dialysis at a private health facility in Ashok Nagar in Delhi. But all things came to a standstill after the lockdown was announced. Ram said, “My brother was treated at Hindu Rao Hospital where we were told that he will need dialysis three times a week. I am an auto driver and worked hard to ensure that my brother gets the much-needed treatment. Despite all our efforts, he could avail the dialysis facility only twice a week. But lockdown has extinguished all our hopes. My earning has dried up. I borrowed from my relatives and friends to support him. But now, they are also reluctant to lend money. He is getting dialysis only once a week. I do not know how we will survive this.”
He added, “I tried approaching my local MLA and even the office of the chief minister, but all offices are closed now. The guards at the offices suggested that I could drop my complaint in the letter box. That’s all we have become, a complaint in a box.”
Several studies in the past have claimed that some 150-230 persons suffer from End-Stage Kidney Disease (ESKD) in every million people in the country, and about 2,20,000-2,75,000 new patients need Renal Replacement Therapy (RRT) every year.
These treatments can push thousands of families below the poverty line. A study published in the British Medical Journal concludes that almost 55 million Indians plunged below the poverty line due to the mounting expenses on health in a single year. The study also stated that the impact of health expenditure could be catastrophic if it is over 10% of the total household expenditure.
Another patient, who had been diagnosed with HIV-AIDS, came to know that she has developed symptoms of oral cancer last month. She visited the B R Ambedkar Institute Rotary Cancer Hospital at All India Institute of Medical Science, Delhi for treatment where she was reportedly told that she will have to wait for six months for her surgery.
However, the doctors suggested that she can visit another centre of the reputed hospital in Jhajjar, Haryana. Talking to NewsClick, her husband said, “We were told that we should visit the hospital in Jhajjar as the surgery would hardly require a waiting period of two weeks. After doctors checked her up, they informed us that her CT scan would be conducted on March 23. But we received a message earlier this month that they have cancelled the appointment for the test and it could be done only when this [coronavirus outbreak] crisis ends.”
The message read, “All Radiology appointments are postponed in view of the Covid-19 crisis. You will be informed when bookings resume to take fresh appointments.”
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The husband added, “After the outbreak, the borders have been sealed. Thus, we were compelled to bring her to the emergency department at AIIMS, Delhi where doctors have prescribed some medicines to deal with the excruciating pain.”
Reports suggest that the AIIMS conducted 12,000 surgeries in a year. As per the International Agency for Research on Cancer, World Health Organisation, 7,84,821 cancer patients died in India in 2018 alone.
NewsClick also came to know about a patient suffering from the other terminal disease who is struggling to get his oxygen cylinder filled up.
Public health organisations like Jan Swasthya Abhiyan have advised the government to take necessary steps before the situation gets out of control. In a statement, it said, “Access to essential health services, especially those that need to be provided in a time- bound manner need to be continued even through a period of lockdown. Otherwise any gains made in COVID prevention will be lost in increasing morbidity and even mortality from other conditions. Some examples of such essential services include continued access to NCD drugs, access to anti-tubercular and anti-retroviral drugs, access to dialysis services, cancer chemotherapy, pregnancy care, abortion care, contraceptive services, emergency services, continued services for those under clinical trials. Similarly, measures should be put in place to ensure an uninterrupted supply of blood to people with blood disorders like Thalassemia who require regular blood transfusions, as also
oxygen cylinders in some other disorders.”
Commenting on the crisis, Ashok Agarwal, an activist who has been helping patients in accessing affordable healthcare services, said that the crisis has been unfolding for years before and it is finally crumbling in the times when patients need healthcare services the most.
He said, “The approach of the state as well as the central government has been to shift the burden of healthcare to the private sector which was already profiteering from people’s miseries. For example, the Institute of Liver and Biliary Sciences is run by the Delhi Government. This hospital admitted a patient who had to undergo kidney transplant. They had paid the money to the hospital and the donor, too, was ready. When he got admitted, Delhi government announced the lockdown and asked the hospitals to reserve beds for coronavirus patients. So, the hospital told his relatives that they could not perform the kidney transplant. But since the patient was already in the ICU, they are charging him almost Rs 50,000 per day. The family has already sold a substantial part of their property to save him. So, the people are bound to suffer because their governments have failed.”
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